About AMSA

Working with Community Groups

If you give me a fish you have fed me for a day. If you teach me to fish then you have fed me until the river is contaminated or the shoreline seized for development. But if you teach me to organize then whatever the challenge I can join together with my peers and we will fashion our own solution. – Ricardo Levins Morales

So you want to put your skills as a medical or pre-medical student to work with grassroots organizations? That’s great, you are desperately needed. Maybe you have done grassroots work before and maybe you haven’t, either way it can’t hurt to do a little planning and to have a little structure on which to hang your thoughts.

Instead of giving you a paint-by-numbers guide telling you what to do in theoretical situations we are presenting a collection of tools and viewpoints that can hopefully be applied as you work through the challenges that come up in community work. This is a condensed collection so if anything really strikes you use the resource page to track down the full text.

First let’s talk a little about what organizing is and what community groups do. For this we are using an example adapted from the School Of Unity and Liberation (SOUL) Political education workshop manual’s Introduction to Organizing workshop produced by the Soul school and part of their training for trainer’s curriculum (2001)

What Is Organizing?

Do you know about Rosa Parks?
Most likely you do and what you know may sound something like this. One day, spontaneously, Rosa Parks was so tired that she didn’t want to give up her seat and decided not to get up, and this sparked the Montgomery Bus Boycott and the civil rights movement.

What else is there to this story? Perhaps this story, and what is left out of it contributes to our confusion about organizing, so let’s look at some of the details.

Rosa Parks was not some random woman who was really tired and just gave up her seat. She was an experienced Civil Rights Organizer who organized the Woman’s Political Caucus and new that when she didn’t give up her seat she would be sparking a movement. It was a planned action, not just an accident.

The lack of this information perpetuates two myths about organizing:

The Superhero myth
The idea that a superhero swoops out of the sky to save the day

The Spontaneous Combustion Myth
The idea that movements happen all of a sudden like a big explosion – usually following a crisis.

How do you think these myths distort our perception of organizing? Do you ever feel like you can save the day like a superhero? Do you ever feel like you need to wait for one? How do these myths devalue the importance of the work of all individuals to contribute to change, or the need to do community work at all?

So what exactly is organizing? Come up with you own definition before going on.

Organizing is the process of bringing people together in order to use their collective power to win improvements in people’s lives and to challenge the power structure.

Let’s compare organizing and other ways to make change with the following problem,

We find that there is a high rate of sexually transmitted infections amongst youth in the community.

There are lots of examples to deal with this problem, to name a few:

Distribution of free condoms through schools and at places students frequent.

Raising awareness about STI’s and how to prevent them.

Organizing to create more funding for comprehensive programs to deal with youth health issues and sexuality.

How can we classify these responses so that in the community we have some guidelines to approaching the problem?

Direct Service: Providing resources to deal with the problem directly and minimize harm.

Education: Spreading awareness about the issue and how it can be resolved.

Organizing: Using collective power to change the system to bring resources to deal with the issue.

So we can see how our solutions to the problem of STI’s amongst the youth all contain elements of direct service, education and organizing. These aspects of social change are fluid and while one may be dominate in a particular project or campaign effective change requires all three.

Community groups work with the people of the community in order to effect change. Individually it may be true that you can’t fight city hall, but collectively city hall works for us, or at least it can be made to do so. Organizing collective power to effect change, whether through political pressure, education, direct service or any mix of the three is heart of democracy and the work of community groups.

“A journey of a thousand miles begins beneath ones feet.” – Lao Tzu

This is a more correct translation of the quote “a Journey of a thousand miles begins with a single step.” The original emphasizes that action arises naturally from stillness, and we would add to that, from knowing where you stand.

Whether you are part of a group of students and professors looking to start a project with a local organization or just an individual student looking to volunteer, before you take that first step it will be useful to understand who you are as a group and where you stand. We present the four phases. The four phases a structured way of thinking that helps determine where you are coming from, what issues you see and what you want to do about them. This will help immensely when trying to establish relationships with community groups and in making sure that you can communicate clearly and create useful collaborations. It is also a useful tool in the continuing cycle of planning, action and reflection that make up the process of working for change.

NAMING THE MOMENT: The Four Phases

We are greatly indebted to the Moment Project for creating the Naming the Moment Manual and to the catalyst centre for reprinting the manual and making it available.

The four phases is a tool produced by the Naming the Moment Project to help groups reflect and plan strategically. It may be helpful to print out this page, and actually write down answers as you talk with your group.

How do we define our constituency? Are we of, with, or for the people most affected by the issue(s) we work on?

What do we believe about the current structure of the society? About what it could be? About how we get there?

Why it is important: If we want to change the structure of society and the course of history we need to see ourselves as part of that society and history. Our analysis will reflect our own interests, who we are in terms of class, race, gender, age, economic status. Our goals will be tied to our own experiences within current power relations. It’s important to talk frankly about the different perspective we bring to the long term questions, even if we don’t agree. The differences, in fact may offer both constraints and possibilities for our proposed action.

PHASE 2- Naming the Issues/Struggles

What current issue/struggle is most critical to the interests of the group?

What are the opposing interests (contradictions) around the issue?

What are we fighting for in working on this issue – in the short-term and in the long-term?

What’s the history of struggle on this issue? What have been the critical moments of the past?

Why it is important: Some groups have very clearly-defined issues, while others may shift issues depending on the moment and need. Defining short term and longer term goals is another way of clarifying why we are working on an issue. It also helps us understand the historical context of the issue we are working on and to situate our present struggle in terms of evolution of the past and where it may go in the future.

PHASE 3- Assessing the Forces

Who’s with us and against us on this issue (in economic, political, and ideological terms)?

What are their short-term and long-term interests?

What are their expressed and real concerns?

What about the uncommitted?

What actors do we need more information about?

What’s the overall balance of forces?

Who’s winning and who’s losing and why?

Why it’s important: In assessing the forces organizing for and against an issue we are coming to terms with who is on our side and who is not. This helps us identify points of intervention on which we can act. It also helps us understand what groups share our long-term and short-term interests and limits to such collaborations. Assessing overall correlations of forces is key to the task, it means coming up with who is winning and on what terms, who’s losing and why.

PHASE 4- Planning for action

How have the forces shifted from the past to the present? What future shifts can we anticipate?

What “free space” do we have to move in?

How do we build on our strengths and weaknesses?

Whom should we be forming alliances with? In the short-term and in the long-term?

What actions could we take?

What are the constraints and possibilities of each?

Who will do what and when?

Why it’s important: This is the payout of political analysis. It helps us make strategic decisions about how to use our organizational resources and energies. We try to identify “free space” where there is room to move and push on the issue. This step requires bold imagination to find strengths and turn liabilities into assets. Fortunately with the critical analysis gained in the other steps we are well prepared and can get creative on adapting our analysis to action.

The reason that we have spent so much time thinking and talking about ourselves is that we are all experts in our own lives. So if you want to help someone you need to start with what they think is important and what they need, because they’re the expert.

We will start with a theoretical example.
It is understood that poverty, malnutrition and obesity go hand in hand. Average well meaning medical students discuss amongst themselves and decide to work with community groups and help the people of the community be healthier. They want to do this by educating about diet and recommending that they purchase fresh and if possible organic fruits and vegetables. They have made materials explaining the benefits of vegetables and organic foods, made lists of vegetables, recipes and even a resource guide for where organic foods can be found.

How effective and attainable will this project be for the members of the community? Well, the people of the community know why they do or do not purchase vegetables, and listening to their experiences will quickly make this clear. If the only grocery store in the neighborhood is a gas station that doesn’t sell produce this is a significant barrier. If the farmers market in the resource guide doesn’t accept food stamps or the cost is still too high for the food budget then the plan will have only limited success. The students come away feeling like “these people” don’t seem to want to change and the community, on the whole, politely ignores the advice and continues to do ,more or less, what it did before.

What could have been done to make this project work?
Dorothy Day, the founder of the catholic worker movement puts it like this, “the goal is to understand, not to be understood.”

This means that if we believe that a person in an expert in their life, which is to say that they have something valuable to say, then it behooves us to listen before we start trying to help. Nobody likes being told what they need, even if it’s done in a well-meaning way. This is especially important given the social status of a physician, who is often looked to for answers and, by dint of their rigorous training, may easily feel comfortable handing them out. In seeking to understand we are humbled, and by listening first we learn how to speak to the others concern, instead of telling them what their problem is.

We have all grown up in a society that is deeply unequal in terms of race, gender, economic status and so forth. It would be foolish to pretend these inequalities don’t permeate our relationships, by understanding ourselves, who we are and who we aren’t, we understand the limits of our experience as well as our strengths. This is the reason for emphasizing self-reflection in the beginning of this guide, so that when it comes time to talk to community groups who may be made up of people very different from you, people who are the experts in their experience. By knowing what we don’t know and listening first, an opportunity arises to expand our collective understanding, with the pragmatic effect of better understanding the issue and being able to address it more effectively.

Had our average medical students discussed their economic status (most medical students come from families in the top 20%) they may have acknowledged the limit of their understanding of poverty, and looked to the community group and its member’s to better their understanding. The same is true if this community is made of people of color and the medical students are predominantly white. The same is true in every situation because if everyone is an expert in their own lived experience, then everyone has something to teach and given the limits of our lived experience, something to learn.

Dialogue is an important tool to make visible the ways in which inequality shapes our experiences. It can help us see how the playing field is not equal which is fundamental to successfully working for change. Talking to people is also the first step in establishing trust, and forging a relationship based on reciprocal exchange of information.

So how do we get from ideals to action? We are here ultimately trying to change things in the real world right? To return to our example:
Had our group began by talking with the community and community groups and reflected on this dialogue, they would realize the gaps in their plan. To address this they could ask members of the community group to advise them on their project, in essence to include the community in the decision making about the community.

They could work with a community group, school or church to hold community events, where recipes from their resource packet were served and the medical students were able to get to know the people. They could ask for recipes and hold a contest to make them as healthy and tasty as possible.

All of this would make the community more willing to hear and utilize the resources prepared by the medical students. Their plans would also probably change to address economic and geographical barriers for the community. They could work with a local farm to set-up a community supported agriculture program (CSA) through a community group or run it with the help of community members. They could work to get food stamps accepted at farmers markets or health food stores and they could use their clout as medical students to advocate for the community to city hall for community garden funding or funding for community health educators.

All of these are hypothetical, but hopefully they point to the real benefit of the approach we have tried to explain in this guide. The way to work with community groups is to build community. By incorporating community participation in your project, by holding public social events in the community and by creating relationships and dialogue the lines between the medical students and the community begin to fade. As the group works together and reflects using the four phases the project becomes less an aid project given to the community by medical students and more the work of the community. It must be noted that giving up control may be hard for some, but this is at the very heart of participatory democracy, the practice of people coming together as equals to achieve things none of them could have done alone, and for the benefit of all.

Resources

If you like what we’ve presented here, you're going to love the original materials put out by these inspiring organizations.